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Treatment Criteria for Eating Disorders Too Narrow?
it isn’t surprising that eating disorders are on the rise considering the emphasis our society places on being thin. Ads in magazines and on the television tend to use the most idealized images of women, touched up and air-brushed to perfection.

Statistics on eating disorders are staggering. According to the American Psychological Association (APA), 10 million people in the United States, mainly women, struggle with anorexia nervosa or bulimia nervosa. Then there are those who show signs of disordered eating yet don’t fit the exact clinical definitions of anorexia or bulimia. These cases are designated eating disorder not otherwise specified, or EDNOS. Binge eating is a type of EDNOS. And it is the sufferers of EDNOS that lack categorization and treatment options, often causing long-term damage.

While eating disorders may start with preoccupations with food and weight, they are most often about much more than food. People with eating disorders often use food and the control of food in an attempt to compensate for feelings and emotions that may otherwise seem overwhelming.

Being diagnosed with EDNOS is "a bit misleading to patients—it can make them feel like they don't have a real eating disorder," said Dr. Rebecka Peebles, an adolescent medicine specialist with the Comprehensive Eating Disorders Program at Lucile Packard Children's Hospital in California.

Dr. Peebles was part of a research team studying the medical records of more than 1,300 female patients treated for eating disorders. Of that group, almost two-thirds were diagnosed with EDNOS, 60 percent of which met medical criteria for hospitalization and, on average, were sicker than patients diagnosed with full-blown bulimia. The sickest of these EDNOS patients had lost more than 25 percent of their body weight before finally being diagnosed and admitted. Many had been overweight to begin with and the weight loss was viewed as a normal progression, although went far beyond normal.

Other findings, published online today in the journal Pediatrics, has led the researchers to suggest that there is a need to re-evaluate and further define eating disorders, particularly EDNOS, and to begin medical intervention and treatment regimens sooner than had been previously considered.